ArticleHead & face medicine2021
A pragmatic window of opportunity to minimise the risk of MRONJ development in individuals with osteoporosis on Denosumab therapy: a hypothesis.
Article in Head & face medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 19 citations in OpenAlex.
- The Effect of Er:YAG Laser Therapy as an Adjunct to Surgical Treatment Compared to Latter Alone in Managing Medication-Related Osteonecrosis of the Jaw: A Randomised Controlled Clinical Trial.International dental journal · 2026Trial
- Management of severe bone loss in patients at risk of medication-related osteonecrosis of the jaw with microsurgery and guided bone regeneration: A case study.Clinical advances in periodontics · 2026Article
- The therapeutic window: timing dentoalveolar surgery to minimize MRONJ risk in denosumab-treated osteoporotic patients.JBMR plus · 2026Article
- Mining the FAERS database reveals new safety signals for 120 mg denosumab in oncology practice.PloS one · 2026Article
- Article
- Effect of anti-resorptive therapy on implant failure: a systematic review and meta-analysis.Journal of periodontal & implant science · 2025Review
- Medication related osteonecrosis (MRONJ) in the management of CTIBL in breast and prostate cancer patients. Joint report by SIPMO AND SIOMMMS.Journal of bone oncology · 2025Article
- Impact of glucocorticoids on the therapeutic efficacy of denosumab against osteoporosis in patients with rheumatoid arthritis.Therapeutic advances in musculoskeletal disease · 2025Article
- Oral and Gingival Crevicular Fluid Biomarkers for Jawbone Turnover Diseases: A Scoping Review.Diagnostics (Basel, Switzerland) · 2024Article
- Bone health and body composition in prostate cancer: Meet-URO and AIOM consensus about prevention and management strategies.ESMO open · 2024Article
- Review
- Anti-resorptive therapy in the osteometabolic patient affected by periodontitis. A joint position paper of the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP).Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2023Review
- Denosumab-associated jaw bone necrosis in cancer patients: retrospective descriptive case series study.Maxillofacial plastic and reconstructive surgery · 2023Article
- Persistence with Denosumab in Male Osteoporosis Patients: A Real-World, Non-Interventional Multicenter Study.Endocrinology and metabolism (Seoul, Korea) · 2023Article
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Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
Abstract
Denosumab is associated with the development of medication-related osteonecrosis of the jaw (MRONJ), an uncommon but severe oral side effect with a higher prevalence in metastatic cancer patients than in patients with metabolic bone fragility. Although several oral triggers can initiate MRONJ, invasive oral treatments and tooth extraction still remain the most common precipitating event. In general, tooth extraction and oral surgery should be avoided in patients at increased risk of MRONJ, while extraction of non-restorable teeth should be performed based on specific risk reduction protocols to eliminate dental/periodontal infections, still protecting from MRONJ onset. Based on the different pharmacological activity of denosumab and nitrogen-containing bisphosphonates, it is likely that the MRONJ risk profile of patients with osteoporosis could somewhat vary. We hypothesize the chance to maximize the pharmacokinetic of denosumab 60 mg (Prolia®) and identify a time interval in which invasive oral treatments can ideally take place without restrictions in patients with metabolic bone fragility, We propose that dental surgery (e.g. tooth extraction) may be safely performed without additional intra or peri-operative procedures in osteoporosis patients using denosumab provided that careful case selection, adequate communication among specialists, planning of a delayed dosing window (1-month deferral) and rigorous postoperative follow-up are granted.
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